Abstract

In South-Africa nurses and doctors are emigrating in significant numbers. Job satisfaction, safety and ensuring career progression are important in retaining doctors to make a career in RSA. Due to budgetary constraints many hospitals have not been upgraded. Coming home after overseas training seems difficult. In RSA it takes a minimum of 13 years for a young specialist to get on the register and 15 years for subspecialists. Career progression, creating more specialist trainees in public and private hospitals and shortening the period of professional training are potential solutions to the problem. India with a population of more than 1 billion people is struggling with similar problems. For the past 10-15 years private hospitals have assisted in manpower development for medical specialist and subspecialist careers. Currently their private sector trains 60% of their recognised (sub)specialities fellows.

A national task force for specialist training in RSA should be instituted. It should discuss, based on the current status and projected specialist and subspecialist personnel requirements, the future structure and logistics of training needs. This is required in all subspecialities including gasteroenterology, as has been done in India. It is hoped that as a consequence well-trained doctors, like in India, might move to provincial hospitals in rural areas, uplifting the medical services and keeping medical power in South-Africa. South-Africa should become a model for Sub-Saharan Africa, as India already is for South-East Asia.